EA - Open Philanthropy Shallow Investigation: Tobacco Control by Open Philanthropy

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Open Philanthropy Shallow Investigation: Tobacco Control, published by Open Philanthropy on January 25, 2023 on The Effective Altruism Forum.1. PreambleThis document is a shallow investigation, as described here. As we noted in the civil conflict investigation and telecommunications in LMICs investigation we shared earlier this year, we have not shared many shallow investigations in the last few years but are moving towards sharing more of our early stage work.This investigation was written by Helen Kissel, a PhD candidate in economics at Stanford who worked at Open Philanthropy for 10 weeks in summer 2022 as one of five interns on the Global Health and Wellbeing Cause Prioritization team. We’ve also included the peer foreword, written by Strategy Fellow Chris Smith. The peer foreword, which is a standard part of our research process, is an initial response to a piece of research work, written by a team member who is not the primary author or their manager.A slightly earlier draft of this work has been read and discussed by the cause prioritization team. At this point, we plan to learn more about this topic by engaging with philanthropists who are already working on tobacco, extending the depth of this research (particularly on e-cigarettes), and digging deeper into countries which have seen big declines in their smoking burden (e.g. Brazil).2. Peer forewordWritten by Chris SmithIt was in 1964 that the US Surgeon General published a report which linked smoking cigarettes with lung cancer, building on research going back more than a decade. The report told readers that smokers had a 9-10x relative risk of developing lung cancer; that smoking was the primary cause of chronic bronchitis; that pregnant people who smoked were more likely to have underweight newborns, and that smoking was also linked to emphysema and heart disease.In this shallow, Helen reports that nearly sixty years later, there are ~1.3B tobacco users, and that smoking combustible tobacco remains an extraordinary contributor to the global burden of disease, responsible for some 8 million deaths (including secondhand smoke) and ~230M normative disability-adjusted life years (DALYs) (~173M OP descriptive DALYs) making it a bigger contributor to health damages in our terms than HIV/AIDS plus tuberculosis plus malaria. Moreover, the forward-looking projections are for only modest declines in the total burden as population increases offset a decline in smoking rates. As our framework puts it, we’ve got an important problem.Helen walks through the conventional orthodoxy on tobacco control at a population level (higher taxes, marketing restrictions, warning labels) and on smoking cessation support (nicotine replacement therapy, pharmaceutical support). She estimates that a campaign for a cigarette tax which increased the retail price of cigarettes in Indonesia by 10% (a large country with a high attributable disease burden) would reduce tobacco consumption (and attributable DALYs) by 5%, having an expected social return on investment (SROI) of ~3,300x, assuming a 3-year speedup, 10% success rate, and $3M campaign cost. Taxes are considered the single most effective policy measure, but going down the ladder to a moderate advertising ban, the subsequent expected 1% reduction in tobacco consumption and associated DALYs would have an SROI of ~500x. As with any of our shallow back-of-the-envelope-calculations (BOTECs), there is room to debate both the structure and the parameter choices.But I think that this is — when combined with the other material — a strong indicator that there could be relatively mainstream tobacco advocacy work which is above our bar in expectation. This suggests a somewhat tractable problem.Ok, but isn’t this addressed? Don’t people already know that cigarettes are bad for you? We...